The Patient Account Representative Is Responsible For:
- Utilize payor websites to get information on eligibility, EOBs, claim status and on-line inquiries:
- Avidity, Aetna, Cigna, Human, WellCare, Tricare, United Healthcare, Amerigroup, Molina
- Ensuring that work queues are worked daily and monitoring follow-up activities.
- Update the system with any follow-up activities that are being worked or completed.
- Report payment variances, claim rejections, payor reimbursement issues, or other system issues immediately to management. Completing research daily on each account which includes
- reviewing EOBS, Ras and correspondence from payors that relate to account activities.
- Monitoring account reimbursement daily to ensure that payments are accurate and processed timely.
- Updating patient demographic, insurance, and other patient information. • Must apply appropriate adjustment on accounts which require additional contractual adjustments or a write-off.
- Review patient accounts to determine the next collection action, whether negotiation payment arrangement or discount, proceeding with legal action, or conducting additional insurance follow-up.
- Research denied claims and determines the appropriate course of action to resolve account balances through EPIC Account work queues.
- Identifies issues that are creating denials and works with associated departments to prevent future denials.
- Previous patient account representative experience
- EPIC
- EOBs, claims, eligibility
- Understanding of major insurance carriers
Resource Staffing is an affiliate of The Reserves Network, a family-owned and veteran-founded company. Since 1989, we have been bringing employers and job seekers together in a variety of industries and positions throughout the great state of Texas.
As an equal opportunity employer, we value our employees and foster an environment of respect, integrity, and trust in every aspect of employment. However you identify and whatever your background, we encourage you to apply today.
#HG